Glaucoma is 5 times more likely to occur in persons of African descent (AD) than in those of European descent (ED) and is the leading cause of blindness in AD individuals. The African Descent And Glaucoma Evaluation Study (ADAGES) is the first prospectively designed multi-center, longitudinal study to follow a well-characterized cohort of glaucoma patients of African Descent on a variety of measures of visual function, optic nerve structure, risk assessment, and clinical results. Purpose: To identify what factors account for the differences in glaucoma onset and rate of progression found between individuals of African descent and those of European descent and to determine whether accounting for these differences can be used to optimize algorithms for detection of glaucoma and for monitoring progression. Aims: To quantify differences in visual function and structure of the retina in glaucomatous individuals from the two ancestry groups. To combine information from structural and functional measures improving both diagnosis and follow-up of progressive glaucoma using modeling of predictive and risk factors, including self-reported race versus genetically determined ancestry. Participants: 364 healthy individuals (218 AD) and 860 patients (693 AD) with or at risk for glaucoma have completed baseline testing and are being followed. Methods: Patient eyes will be followed with annual testing for 5 additional years on standard clinical perimetry, and two function-specific tests. Optic nerve structure will be qualitatively evaluated with stereoscopic fundus photography and quantitatively using three retinal imaging devices. Importance: At the conclusion of this study, practitioners should be able to understand any differences in visual function and optic nerve structure between the two ancestry groups, and how to account for them when interpreting the results from both the routine and promising new procedures evaluated in this study. Better documentation of the magnitude and rate of glaucomatous changes will assist clinicians in determining whether and how aggressively patients should be treated. A greater understanding of the importance of ancestry and other risk factors for development and progression of glaucoma will result.